Provider Demographics
NPI:1386376481
Name:BRENDT LUM, DDS LLC
Entity type:Organization
Organization Name:BRENDT LUM, DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-247-5373
Mailing Address - Street 1:45-880 KAMEHAMEHA HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744
Mailing Address - Country:US
Mailing Address - Phone:808-247-5373
Mailing Address - Fax:
Practice Address - Street 1:45-880 KAMEHAMEHA HWY
Practice Address - Street 2:STE 102
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744
Practice Address - Country:US
Practice Address - Phone:808-247-5373
Practice Address - Fax:808-235-6671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental